In order for us to process your RMA we will need you to complete this form. Once you submit your information our Customer Representative will contact you within a timely fashion.

Personal Information
Please enter all applicable information so we may process your request fully. * indicates a required field.
* First Name:
* Last Name:
* Department:
* Title:
* Company:
* Country:
* Address:
 
* City:
* State:
* Zip:
* Phone:     Ext.  
   
Fax:
* Email:

Repair / Product Information
Sales Order No.


Invoice No.


PO No.


Return / Repair #1:
Model No.  Item No.  Serial No. 

Capacity 

Questions or Comments




"Once your RMA has been submitted, a FUTEK customer service representative will contact you"